Submit Your Request - Elmore Law Group

Name*

Email*

Phone*

Is your case in the appeals process?*

Yes
No

Is your case an initial claim?*

Yes
No

What medical conditions are you trying to service connect?*

Agree to terms:*

I agree to the terms.

I give permission to Elmore Law Group to refer my case details to an external law firm who specializes in VA disability claims. I agree that Elmore Law Group is not the attorney of record on your claim nor is there any attorney-client relationship established by submitting your case information with Elmore Law Group. l understand there may be additional fees owed to the referred law firm who represents my case, as outlined in any agreement signed with that law firm.